Signs, Symptoms, and Complications of Sleep Apnea
- Excessive daytime sleepiness (EDS) and impaired alertness
- Increased risk of driving and work-related accidents
- Moodiness, belligerence, and decreased attentiveness and energy
- Higher risk of diabetes
- Lack of awareness or misdiagnosis due to varied symptoms
- Daytime fatigue, sleepiness, cardiovascular problems, and eye problems
- Increased risk of severe complications of COVID-19
- Higher risk of developing other medical conditions
- Sleep-disordered breathing is associated with an increased risk of cardiovascular disease, stroke, and high blood pressure
- Daytime functioning problems include sleepiness, motor vehicle crashes, and decreased cognitive functioning
- Psychological problems and reduced quality of life are also associated with sleep apnea
- Stroke and cerebrovascular diseases are linked to obstructive sleep apnea
- Sleep apnea can contribute to hypertension that persists during sleep

Mechanism of Sleep Apnea
- Build-up of carbon dioxide in the bloodstream triggers awakening and clears the airway
- Decreased output of the brainstem regulating chest wall or pharyngeal muscles causes pharynx collapse
- Reduced or no slow-wave sleep and less time in REM sleep

Diagnosis of Sleep Apnea
- Medical consensus and debate regarding apneic events and variability of patients' physiologies
- Use of multi-criteria decision rule to account for variability in defining events
- Polysomnography as the gold standard for diagnosis
- Oximetry as a simpler alternative for home testing
- Variability and limitations of equipment and methods

Frequency, Statistics, and Risk Factors of Sleep Apnea
- Sleep apnea affects approximately 1 in every 10 people globally
- Higher prevalence in men than women (2:1 ratio)
- Aging and obesity increase the risk
- Lack of awareness and underutilization of CPAP machines in developed and developing countries
- Association between sleep apnea and increased risk of various medical conditions, including Alzheimer's disease.
- Obstructive Sleep Apnea (OSA) accounts for 84% of cases
- Central Sleep Apnea (CSA) accounts for 0.9% of cases
- Mixed sleep apnea accounts for 15% of cases
- OSA is the most common category of sleep-disordered breathing
- CSA is characterised by a lack of respiratory effort during sleep
- Low muscle tone and soft tissue around the airway increase the risk of OSA
- Structural features that narrow the airway also contribute to the risk
- Obesity is a significant risk factor for developing OSA
- The risk of OSA increases with age, especially in the elderly
- Men are more likely to develop sleep apnea than women and children
- Common symptoms include loud snoring, restless sleep, and daytime sleepiness
- Diagnostic tests include home oximetry and polysomnography
- Hypoxemia (low blood oxygen) and sleep deprivation are complications of severe OSA
- Snoring, in combination with other risk factors, is highly predictive of OSA
- Up to 78% of genes associated with habitual snoring also increase the risk for OSA

Treatment Options for Sleep Apnea
- Lifestyle changes such as avoiding alcohol and losing weight can help manage OSA
- Sleeping at an elevated position or on the side can prevent airway collapse
- Oral appliances like the Mandibular advancement splint can keep the airway open
- Continuous positive airway pressure (CPAP) is the most effective treatment for severe OSA
- Surgical procedures may be recommended to remove or tighten tissue and widen the airway